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The association between preoperative chemotherapy and the prevalence of hepatic steatosis in hepatectomy for metastatic colorectal cancer / Associação da quimioterapia pré-operatória e a prevalência de esteatose hepática em hepatectomias por metástase de câncer colorretal
KALIL, Antonio Nocchi; CORAL, Gabriela Perdomo; SANTOS, Félix Antônio Insaurriaga dos; GONZALEZ, Maria Cristina; NEUTZLING, Cristiane Becker.
Affiliation
  • KALIL, Antonio Nocchi; Hospital Complex of Irmandade Santa Casa of Porto Alegre. Post-Graduation Program in Hepatology. Hepatobiliary Cancer Surgery Unit of Santa Rita. Porto Alegre. BR
  • CORAL, Gabriela Perdomo; Hospital Complex of Irmandade Santa Casa of Porto Alegre. Post-Graduation Program in Hepatology. Hepatobiliary Cancer Surgery Unit of Santa Rita. Porto Alegre. BR
  • SANTOS, Félix Antônio Insaurriaga dos; Hospital Complex of Irmandade Santa Casa of Porto Alegre. Post-Graduation Program in Hepatology. Hepatobiliary Cancer Surgery Unit of Santa Rita. Porto Alegre. BR
  • GONZALEZ, Maria Cristina; Hospital Complex of Irmandade Santa Casa of Porto Alegre. Post-Graduation Program in Hepatology. Hepatobiliary Cancer Surgery Unit of Santa Rita. Porto Alegre. BR
  • NEUTZLING, Cristiane Becker; Hospital Complex of Irmandade Santa Casa of Porto Alegre. Post-Graduation Program in Hepatology. Hepatobiliary Cancer Surgery Unit of Santa Rita. Porto Alegre. BR
ABCD (São Paulo, Impr.) ; 27(2): 120-125, Jul-Sep/2014. tab, graf
Article in English | LILACS | ID: lil-713573
Responsible library: BR1.1
ABSTRACT

BACKGROUND:

Some studies have suggested that preoperative chemotherapy for hepatic colorectal metastases may cause hepatic injury and increase perioperative morbidity and mortality.

AIM:

To evaluate the prevalence of hepatic steatosis in patients undergoing preoperative chemotherapy for metastatic colorectal cancer.

METHODS:

Observational retrospective cohort study in which 166 patients underwent 185 hepatectomies for metastatic colorectal cancer with or without associated preoperative chemotherapy from 2004 to 2011. The data were obtained from a review of the medical records and an analysis of the anatomopathological report on the non-tumor portion of the surgical specimen. The study sample was divided into two groups those who were exposed and those who were unexposed to chemotherapy.

RESULTS:

From the hepatectomies, 136 cases (73.5%) underwent preoperative chemotherapy, with most (62.5%) using a regimen of 5-fluorouracil + leucovorin. A 40% greater risk of cell damage was detected in 62% of the exposed group. The predominant histological pattern of the cell damage was steatosis, which was detected in 51% of the exposed cases. Exposure to chemotherapy increased the risk of steatosis by 2.2 fold. However, when the risk factors were controlled, only the presence of risk of hepatopathy was associated with steatosis, with a relative risk of 4 (2.7-5.9).

CONCLUSION:

Patients exposed to chemotherapy have 2.2 times the risk of developing hepatic steatosis, and its occurrence is associated with the presence of predisposing factors such as diabetes mellitus and hepatopathy. .
RESUMO
RACIONAL Alguns estudos sugerem que a quimioterapia pré-operatória para metástases hepáticas do câncer colorretal pode causar dano celular e aumentar morbidade e mortalidade.

OBJETIVO:

Analisar a prevalência de esteatose hepática em fígados de pacientes expostos à quimioterapia pré-operatória por metástase de câncer colorretal.

MÉTODOS:

O delineamento do estudo foi observacional de coorte retrospectivo, no qual 166 pacientes foram submetidos a 185 hepactectomias por metástase de câncer colorretal, com e sem quimioterapia pré-operatória, no período de 2004 a 2011. Os dados foram extraídos da revisão dos prontuários e da análise do laudo anatomopatológico da parte não tumoral da peça cirúrgica. A amostra foi dividida em grupo exposto e não-exposto à quimioterapia. Os dados foram analisados por programa estatístico Stata 11.2, e aplicado o teste exato de Fischer para análise bivariada, e a regressão de Poisson, para análise multivariada; valores p< 0,05 foram considerados como significativos.

RESULTADOS:

Das hepatectomias, 136 casos (73,5%) receberam quimioterapia pré-operatória, e o regime mais utilizado (62,5%) foi 5-fluorouracila+leucovorin. No grupo exposto, a lesão hepatocelular esteve presente em 62% dos casos e correspondeu a risco de 40% em relação ao grupo não-exposto. O padrão histológico da lesão hepatocelular predominante foi a esteatose, em 51% de casos do grupo exposto. A exposição à quimioterapia aumentou em 2,2 vezes a possibilidade de esteatose. Entretanto, quando foram controlados os fatores de risco, somente a hepatopatia prévia esteve associada à presença de esteatose após quimioterapia com risco relativo de 4 (2,7-5,9).

CONCLUSÕES:

Pacientes expostos ...
Subject(s)


Full text: Available Collection: International databases Health context: SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases Health problem: Colon and Rectum Cancers / Digestive System Diseases / Liver Cancer Database: LILACS Main subject: Preoperative Care / Colorectal Neoplasms / Fatty Liver / Hepatectomy / Liver Neoplasms / Antineoplastic Agents Type of study: Etiology study / Incidence study / Observational study / Prevalence study / Risk factors / Screening study Limits: Aged / Female / Humans / Male Language: English Journal: ABCD (São Paulo, Impr.) Year: 2014 Document type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Complex of Irmandade Santa Casa of Porto Alegre/BR

Full text: Available Collection: International databases Health context: SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases Health problem: Colon and Rectum Cancers / Digestive System Diseases / Liver Cancer Database: LILACS Main subject: Preoperative Care / Colorectal Neoplasms / Fatty Liver / Hepatectomy / Liver Neoplasms / Antineoplastic Agents Type of study: Etiology study / Incidence study / Observational study / Prevalence study / Risk factors / Screening study Limits: Aged / Female / Humans / Male Language: English Journal: ABCD (São Paulo, Impr.) Year: 2014 Document type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Complex of Irmandade Santa Casa of Porto Alegre/BR
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